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Questions and Answers
What is the primary reason why women are more susceptible to infections during pregnancy?
Which management tool should be used to identify red flags in suspected sepsis during pregnancy?
How quickly must antibiotics be administered in response to the onset of sepsis in a maternity patient?
In which scenarios should a maternity patient be conveyed to an obstetric unit?
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What constitutes a critical condition that would warrant immediate action for a maternity patient?
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What is the implication of utilizing the NEWS2 scoring system for maternity patients?
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What is the recommended action if a midwife is called in the presence of red flags?
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Which of the following identifies a direct cause of maternal sepsis?
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What is the primary characteristic of pre-eclampsia?
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Which of the following symptoms is associated with severe pre-eclampsia?
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Which risk factor is NOT associated with pre-eclampsia?
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What is the appropriate positioning for a pregnant woman with suspected pre-eclampsia during conveyance?
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Which of the following statements about eclampsia is accurate?
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What is the most critical type of red flag feature to assess for in a patient suspected of having pre-eclampsia?
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What can organ dysfunction in severe pre-eclampsia lead to?
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During an ABCDE assessment for a woman with suspected pre-eclampsia, what aspect is important to monitor continuously?
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Study Notes
Pre-eclampsia
- Characterized by new hypertension (≥140/90 mmHg) and proteinuria after 20 weeks of gestation.
- Proteinuria indicates organ dysfunction.
- Risk factors include:
- First pregnancy
- Age 40 or older
- Pregnancy interval more than 10 years
- Body mass index of 35 or higher
- Family history of pre-eclampsia
- Multiple pregnancy
- Pre-existing medical conditions (hypertension, renal or cardiac disease, diabetes).
Management of Pre-eclampsia
- Conduct an ABCDE assessment and report findings.
- Identify time-critical features/red flags; pre-alert to the nearest obstetric unit if present.
- If no urgent features, continue thorough assessment.
- During transport:
- Position patient in right or left lateral position.
- Monitor blood pressure continuously.
- Severe pre-eclampsia can lead to life-threatening conditions such as sub-arachnoid hemorrhage and stroke.
Eclampsia
- Defined by new onset convulsions during pregnancy or postpartum, typically in cases of pre-eclampsia.
- Presents as tonic/clonic convulsions; seizures are brief.
- Requires IV access and medication if paramedics are on site.
Maternal Sepsis
- Ante-partum and post-partum sepsis are significant causes of maternal mortality in the UK.
- Can have direct causes related to pregnancy or indirect causes (e.g., influenza, COVID-19).
- Pregnant women have reduced immunity, increasing infection risk.
- Rapid onset is common.
Management of Suspected Sepsis
- NEWS2 is not validated for assessing sepsis in pregnancy; use the Maternity Assessment Card to check for red flags.
- Pre-alert the obstetric unit; antibiotics must be administered within one hour of suspected sepsis onset.
- Red flags or two amber flags indicate critical condition.
- Transport to maternity unit if ≥20 weeks gestation and stable; otherwise, convey to ED if <20 weeks or unstable.
Summary of Key Actions
- Continuous assessment for suspected pre-eclampsia until patient handover at the hospital.
- Utilize the maternal assessment card to direct assessment and management of pregnancy complications.
- Request additional resources promptly without scene delays.
- Avoid calling a midwife in the presence of red flags to prevent care delays, unless the patient opts not to transfer.
- Document all cases of pregnancy complications on Datix.
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Description
This quiz covers the definitions, risk factors, and management strategies associated with pre-eclampsia and eclampsia. Understand the clinical signs, urgency in treatment, and critical assessment protocols. Perfect for healthcare professionals needing a refresher on maternal health issues.
